Upper Gastrointestinal Endoscopy (esophagogastroduodenoscopy, EGD) is a commonly used examination of the upper gastrointestinal tract employing a flexible fiberoptic endoscope. Other versions of the flexible Upper GI Endoscope are available for examination of the small intestine (enteroscopy), performing ERCP (Endoscopic retrograde Cholangiopancreatography), TEE (Transesophageal Echocardiography), esophageal and mediastinal ultrasonography. The basic instrument is 100 centimeters in length and is controlled by a handpiece that utilizes dials for altering the direction of the tip of the endoscope, and valves for controlling suction and air and water insufflation. An umbilical connects the handpiece of the instrument to a tower of electromechanical modules supplying suction, airflow, and water. An electronics package connected to the endoscope controls light and photography functions. The endoscope has an operating channel allowing the endoscopist to take biopsies and remove tissue from within the upper gastrointestinal tract.
The patient is brought to the endoscopy suite and the posterior oral pharynx is anesthetized with a topical anesthetic either swallowed or sprayed into the appropriate area. The patient is placed in the left lateral position with the head supported on a pillow. The patient is sedated or anesthetized with one of a variety of injectable agents administered in the intravenous access site. An appropriate drape is applied to the patient cart and to the patient in order to protect the patient, the environment, and the operator from any secretions from the upper GI tract during the procedure. An oral-pharyngeal suction cannula is available for assistance in keeping the mouth and the pharynx clear of secretions. The endoscope is brought up into the field and a bite block is used, if necessary, to prevent the patient from inadvertently biting the endoscope. The bite block is either placed between the incisors or placed on the shank of the endoscope for insertion between the incisors after the endoscope is placed in the esophagus. While the working end of the endoscope is inserted through the mouth and into the esophagus an assistant may hold the handpiece of the endoscope at the upper corner of the patient cart near the face of the patient, or the handpiece could be placed on the cart.
The problem arises that this employs the use of personnel who could be used elsewhere in the room to assist with other tasks. Placing the endoscope on the corner of the pillow or the patient cart can result in the endoscope sliding off of the cart and falling onto the floor while the endoscopist's attention is directed to the insertion of the endoscope into the patient's esophagus. Inadequate draping materials and methods frequently result in soiling and contamination of the patient, the patient cart, the endoscopist, and the endoscopy suite.
There is no specific item available to cover and protect the patient and the patient cart. Current practice consists of draping the patient with a disposable, movable plastic drape or a washable towel that is not impermeable to liquids. There is no specific item available to assist in managing the endoscope before, during, and after the endoscopy.
Soiling and contamination of the patient, the patient cart, the endoscopist, and the endoscopy suite environment can easily result without appropriate and adequate draping materials and methods. Clean-up is prolonged and timely transfer of the patient from the endoscopy suite is delayed by soiling and contamination. The utility and security of the endoscope is compromised by the lack of a secure holder for the endoscope during various stages of the procedure.
It is therefore an object of the invention to control secretions and eliminate soiling and contamination of the patient, the patient cart, the endoscopist, and the environment.
It is another object of the invention to support and protect the endoscope at various times during the procedure.